This study aimed to review evidence on the ability of red cell distribution width (RDW) to predict mortality and poor functional outcomes after acute ischemic stroke (AIS). Databases of PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched online from inception to 25th Jul 2023 for all studies reporting the association between RDW and outcomes as adjusted ratios. A random-effects meta-analysis was done. Meta-regression was conducted using multiple moderators. 15 studies with 14,968 patients were included. Meta-analysis found that RDW, both as a categorical variable (OR: 2.10 95% CI: 1.74, 2.55 I2 = 42%) and continuous variable OR: 1.16 95% CI: 1.05, 1.28 I2 = 64%) was a significant predictor of mortality after AIS. Age and number of hypertensives were found to be significant moderators in the meta-regression. Also, high RDW, as a categorical variable (OR: 1.68 95% CI: 1.20, 2.35 I2 = 84%), was associated with significantly higher odds of poor functional outcomes after AIS, but not as a continuous variable (OR: 1.07 95% CI: 0.99, 1.16 I2 = 61%). Meta-regression showed that the association was stronger in small sample-sized studies. RDW can be a useful, readily available, and cost-effective biomarker to rapidly stratify AIS patients at risk of poor outcomes. High RDW was consistently associated with an increased risk of mortality after AIS, however, its ability to predict poor functional outcomes needs to be verified by further studies.

中文翻译：

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红细胞分布宽度作为急性缺血性中风后死亡率和不良功能结果的预测因子：荟萃分析和荟萃回归

本研究旨在回顾红细胞分布宽度 (RDW) 预测急性缺血性卒中 (AIS) 后死亡率和不良功能结果能力的证据。从成立到 2023 年 7 月 25 日，在线检索了 PubMed、CENTRAL、Scopus、Embase 和 Web of Science 的数据库，以查找报告 RDW 与结果之间关联（以调整后的比率表示）的所有研究。进行了随机效应荟萃分析。元回归是使用多个主持人进行的。纳入了 15 项研究，涉及 14,968 名患者。荟萃分析发现，RDW 作为分类变量（OR：2.10 95% CI：1.74、2.55 I2 = 42%）和连续变量 OR：1.16 95% CI：1.05、1.28 I2 = 64%）都是显着的预测因子AIS 后的死亡率。研究发现，年龄和高血压患者数量是元回归的重要调节因素。此外，高 RDW 作为分类变量（OR：1.68 95% CI：1.20、2.35 I2 = 84%）与 AIS 后功能不良结果的几率显着较高相关，但作为连续变量则不然（OR：1.07 95 % CI：0.99，1.16 I2 = 61%）。荟萃回归表明，小样本研究中这种关联性更强。 RDW 是一种有用、易于获得且具有成本效益的生物标志物，可快速对面临不良结果风险的 AIS 患者进行分层。高 RDW 始终与 AIS 后死亡风险增加相关，然而，其预测不良功能结果的能力需要进一步研究来验证。